1 Antipsychotic

Question 1

What is a psychosis?

Answer 1

a group of mental disorders characterized by marked thought disturbance and an impaired
perception of reality.

Question 2

How common is schizophrenia?

Answer 2

The most common form of

psychosis, with 1% of the world population diagnosed with the disorder

Question 3

What causes schizophrenia?

Answer 3

Genetic (primarily) and environmental factors, like social stresses, prenatal or childhood brain injury

Question 4

What causes schizophrenia (at a neurological level)?

Answer 4

-Schizophrenia appears to be caused by an overactivity of dopamine pathways in certain parts of the brain (limbic system).

• The increased dopaminergic activity
  seems to initiate psychosis.

Question 5

What is the mechanism of action for antipsychotic drugs?

Answer 5

• Antipsychotic drugs used to successfully treat schizophrenia block central dopamine receptors.
• These drugs are structurally similar to dopamine, but they do not activate it.

Question 6

Which dopamine receptors do antipsychotic drugs work on?

Answer 6

D2

Question 7

What are the two categories for antipsychotic medications?

Answer 7

Traditional and atypical

Question 8

What are traditional antipsychotics?

Answer 8

• Are associated with more side effects

• Increased incidence of
extrapyramidal (motor) side effects

• Bind to several types of CNS
dopamine receptors, including the
receptors that influence motor
function.

Ex. Haldol and Prolixin

Question 9

Which is associated with more side effects; traditional antipsychotic medications or atypical?

Answer 9

Traditional

Question 10

Haldol and Prolixin are _____ potency, and

when used in ______ dose, can exert a beneficial effect.

Answer 10

High potency
Low dose

(Antipsychotic)

Question 11

Thorazine and Mellaril have ______ potency,
and must be used in _____ dose to exert an
antipsychotic effect.

Answer 11

Low potency
High dose

(Antipsychotic)

Question 12

Which side effects accompany Thorazine and Mellaril?

Answer 12

They’re antipsychotics that have decreased motor side effects but increased

• sedation
• dry moth
• constipation
• urinary retention

Question 13

Atypical antipsychotic medicine

Answer 13

• These drugs have a much better side-effect profile, including a decreased risk of producing motor side effects.
• They affect dopamine receptor subtypes differently that Traditional drugs, as they do not block the D2 receptors in the basal ganglia
• These drugs have a beneficial effect on serotonin and acetylcholine, which improve cognition, and reduce social withdrawal.

Ex: Clozaril and Risperdal

Question 14

How are antipsychotic drugs metabolized?

Answer 14

They’re oxidized in the liver

Question 15

What is tardive dyskinesia?

Answer 15

• Characterized by a number of involuntary and fragmented movements.
• Rhythmic movements of the mouth, tongue, jaw, are present with involuntary sucking and smacking noises.
• 24% of people with chronic psychosis have tardive dyskinesia.
• Symptoms may disappear if the drug is stopped, but this takes several weeks to several years.
• In some, tardive dyskinesia is irreversible.
• Pt’s given benzodiazepines and calcium channel blockers to decrease symptoms.

Question 16

What are the symptoms of neuroleptic malignant syndrome?

Answer 16

Symptoms of NMS; 
catatonia,
stupor, 
rigidity, 
tremors, 
and fever.

Death if untreated